MEDICARE: UNIVERSITY OF ALABAMA AT BIRMINGHAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207RI0200X	Infectious Disease Physician
2	2084P0800X	Psychiatry Physician
3	208M00000X	Hospitalist Physician
4	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	Q991	OTHER	AL	BCBS

General Provider Information

NPI Number	:	1184738478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY OF ALABAMA AT BIRMINGHAM

Provider Business Mailing Address
First Line	:	2055 E SOUTH BLVD
Second Line	:	SUITE 202
City	:	MONTGOMERY
State	:	AL
Zip	:	36116-2002
Country	:	US
Telephone Number	:	334-284-5211
Fax Number	:	334-284-9020

Provider Business Practice Location Address
First Line	:	2055 E SOUTH BLVD
Second Line	:	SUITE 202
City	:	MONTGOMERY
State	:	AL
Zip	:	36116-2002
Country	:	US
Telephone Number	:	334-284-5211
Fax Number	:	334-284-9020

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JEFF DENNEY
Credential	:
Telephone Number	:	205-229-0178

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	07/25/2023

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Directions to “UNIVERSITY OF ALABAMA AT BIRMINGHAM ” Practice Location

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